This 39 year old patient presented with a history of two prior unsuccessful hair transplants in which a total of 3086 grafts had been placed in an attempt to restore his frontal male pattern baldness. He expressed concern that the procedures failed to produce any substantial regrowth or density gain. He was also bothered by a very wide scar that resulted from his second strip harvest procedure.
The prior transplant zones demonstrated quite low density in consideration of the prior 3086 grafts that had been performed. His donor area revealed a very wide scar extending from the occipital region to the right temple donor region. Overall his donor area was deemed compromised because of the past harvests and the resulting wide scar. The surgical plan devised included another strip harvest in the remaining higher density, core donor region, and a secondary FUE harvest for recruiting grafts from the nape region. This combination approach was used to maximize the graft harvest while minimizing further cosmetic handicap in the donor region. The strip harvest yielded 2829 grafts and the FUE harvest yielded 541 grafts, resulting in a total of 3370 grafts for the restoration. Strip grafts were primarily distributed in the frontal and midscalp regions, while the finer nape hairs were used to create a transitional thinning appearance from the midscalp into the crown. Presented here are nine month postoperative results. Also presented are various photos of immediate graft placement and the harvest zone.
Preop Front
Preop Top 1
Preop Top 2
Preop Top 3
Preop Left
Preop Right
Postop Front
Postop Top 1
Postop Top 2
Postop Top 3
Postop Left 1
Postop Left 2
Postop Right
Planned Graft Zones
Immediate Postop Strip Graft Placement View 1
Immediate Postop Strip Graft Placement View 2
Immediate Postop FUE Graft Placement
Immediate Postop Combo Graft Placement
Immediate Postop FUE Donor Site Appearance
FUE Donor Site 24 Hours After Surgery

This 23-year-old gentleman had a hair loss pattern similar to a class 3 on the Hamilton Norwood hair loss scale. His goal was to rebuild his hairline and add density to the frontal 1/3-1/2 of his scalp. Taking his age and hair loss into consideration we came upon an agreement for what would suite his expectations. After establishing his medical history and understanding the progression of his hair loss, I diagnosed his condition as Androgenetic Alopecia (male pattern baldness), ruling out any other possible dermatological or medical conditions which can cause hair loss. The patient’s goal was well suited to his needs and therefore I planned the surgery accordingly. I wanted to reconstruct a hairline that would be suitable for him as he continued to age. A total of 3,071 grafts were used. I used a significant amount of single hair follicular units which allowed me to create a very natural hairline. This action will allow him to comb his hair without anyone detecting that he has had anything done. These are his results 7 months post-op and he will continue to get more improvement over the next 6 months. The patient is extremely happy with his results.This 23-year-old gentleman had a hair loss pattern similar to a class 3 on the Hamilton Norwood hair loss scale. His goal was to rebuild his hairline and add density to the frontal 1/3-1/2 of his scalp. Taking his age and hair loss into consideration we came upon an agreement for what would suite his expectations. After establishing his medical history and understanding the progression of his hair loss, I diagnosed his condition as Androgenetic Alopecia (male pattern baldness), ruling out any other possible dermatological or medical conditions which can cause hair loss. The patient’s goal was well suited to his needs and therefore I planned the surgery accordingly. I wanted to reconstruct a hairline that would be suitable for him as he continued to age. A total of 3,071 grafts were used. I used a significant amount of single hair follicular units which allowed me to create a very natural hairline. This action will allow him to comb his hair without anyone detecting that he has had anything done. These are his results 7 months post-op and he will continue to get more improvement over the next 6 months. The patient is extremely happy with his results.
YouTube Video of Patient Results

This 34 year old patient presented with a history of three prior hair restoration procedures that were performed by three different surgeons. He was unhappy with the lack of density and patchy appearance in the prior transplant zones. The patient also expressed concern about the visibility of his strip harvest scar. His examination revealed very low frontal and midscalp density which was of concern in light of him having undergone three prior procedures.
Restoration of the density deficient frontal and midscalp regions, as well as the donor strip scar, was performed using a total of 1940 grafts that were obtained using an FUE harvest. The scar was treated with 300 grafts and the frontal/midscalp regions were managed with 1640 grafts. Presented here are preop and postop pics which demonstrate the final frontal/midscalp density and donor scar camouflage that was accomplished.
Preop Front
Preop Right Donor
Preop Center Donor
Preop Left Donor
Postop Front
Postop Top View 1
Postop Top View 2
Postop Top View 3
Postop Top View 4
Postop Right View 1
Postop Left View 1
Postop Right View 2
Postop Left View 2
Postop Right View 3
Postop Left View 3
Postop Center Donor
Postop Right Donor
Postop Left Donor
Graft Placement Zone - 5 Days Postop
Donor Scar Graft Placement - 5 Days Postop

This 55 year old male presented with a request to solidify his recessed hairline, enhance midscalp density, and soften the balding appearance in the crown region. He was not able to shave his scalp for the restoration procedure. A total of 3194 grafts were used with a stick-and-place insertion technique. Density transitions were prioritized in a front-to-back fashion so as to maximize his frontal appearance. Presented are one-year postop photos.

This patient first presented at the age of 62 with a request for hairline restoration and coverage throughout the rest of his balding scalp. His restoration consisted of 4681 grafts which created a new frontal hairline and distributed a thinner but natural coverage over his midscalp and crown. He returned to the office almost 5 years later for a follow-up exam. He is now almost 67 years of age and here are photos from his most recent visit.

This 38 year old patient requested density enhancement in his thinning frontal and midscalp regions. His exam revealed a diffuse thinning pattern throughout the male pattern zone. The donor area showed low caliber hair and evidence of retrograde alopecia. He underwent a 3088 graft restoration of the frontal and midscalp regions. Presented are fourteen month postop results. These include part views in the graft zones that demonstrate his density enhancement.
Preop Front
Preop Top
Preop Right
Preop Left
Postop Front 1
Postop Front 2
Postop Top
Postop Right 1
Postop Right 2
Postop Right 3
Postop Left 1
Postop Left 2
Density Inspection Center
Density Inspection Front
Density Inspection Right
Density Inspection Left
Postop Donor Area
Immediate Postop Graft Placement

This 42-year-old gentleman had diffused thinning through the frontal ½ of his scalp. He elected to go with a FUT procedure. He received 3,257 grafts. These are his results 1-year post-op. The patient is extremely happy with his results.

This 27-year-old patient was a class 3. He was looking to rebuild his hairline and add density to the frontal 1/3 of his head. He elected to go with a FUE procedure. He received 2,880 grafts. These are his results 8 months post-op, he will get more improvement over the next 6 months. The patient is extremely happy with his results. He does understand that there is a possibility that he can lose more of his own hair over the years.
YouTube Video

This 29 year old patient requested reinforcement of his frontal hairline. A total of 2204 grafts were transplanted using a non-shave, stick-and-place approach. Presented here is his eighteen month postop result.

This 30-year-old patient was a class 4v. This patient wanted to have his frontal area restored. He elected to go with a FUE procedure. He received 2,592 grafts. These are his results 7 months post-op. His results will continue to improve over the next 5-7 months. The patient is extremely happy. He does understand that there is a possibility he can lose more of his hair over the years. He is planning on coming back to restore his crown at a later time.

This discussion summarizes the 14 year journey of a patient who presented to my office in 2003 complaining of a very unnatural hairline. He had previously undergone hairline restoration using large plug-type grafts. The large size of those grafts, in combination with highly contrasting skin/hair characteristics, left him with an unnatural, surgical-looking hairline. His primary objective was to improve his frontal appearance without using an aggressive hairline excision, as has been discussed here previously (http://www.hairrestorationnetwork.com/eve/143279-advanced-plug-hairline-repair-dr-raymond-konior.html ). His secondary goal was to enhance density in the area behind the frontal plugs using front-to-back prioritization. The chosen strategy for accomplishing these goals was one that would debulk the offending large grafts, which would then be dissected into follicular units and redistributed in the thinning areas behind the grafted frontal region. Additional follicular unit grafts would be obtained using strip harvesting to further supplement density in the thinning midscalp, working back over time toward the crown. The patient was aware that the limitations of extraction and donor supply would require the use of several staged procedures to accomplish his goals. Large punches were used in the early years to perform macro-debulking of the plug-type grafts. As FUE punch technology evolved and improved, small FUE punches were subsequently implemented beginning in 2011 at which time micro-debulking was utilized to selectively remove higher-caliber, darker-hair follicular units from the remaining objectionable plug-type grafts. Over 14 years the patient transformed from having an extremely unnatural hairline that required creative styling for camouflage, to having a natural hairline that allowed him to fully expose it without concern of detectability. Additionally, large-graft redistribution, along with follicular unit grafting from supplementary donor harvests, provided respectable coverage throughout the thinning midscalp and crown regions, despite the progression of his balding over 14 years.
Chronological Highlights:
2003 – Patient presents with unnatural, pluggy hairline. The plan was to debulk the largest grafts (some marked with purple) and to add single-hair grafts to the hairline for softening the harsh appearance. Top view shows extent of thinning in the midscalp and crown regions. Grafts dissected from the extracted large grafts and additional strip harvest grafts were placed into the midscalp.
2004 – Hairline softening is observed one-year postop. Additional debulking and grafting were performed as in the 2003 session.
2006 – Hairline shows further softening from the 2004 session. Additional macro-debulking of large grafts (purple surgical marker) was performed.
2011 – Hairline is looking better, but continues to show some tuft formation. Midscalp density has improved from prior sessions. Further refining of the hairline is now accomplished with micro-debulking using FUE from the remaining large grafts. Extracted grafts and follicular units obtained from a small donor harvest are placed into the crown region.
2014 – Hairline shows more refinement following the FUE micro-debulking session. Additional micro-debulking is performed.
2017 – End result after 14 years of macro-debulking, micro-debulking, and follicular unit grafting. Patient can fully expose the hairline and sports decent midscalp and crown coverage.

This 28 year old requested frontal hairline restoration. A session consisting of 2884 grafts was performed using a “stick-and-place” insertion technique and dense-pack placement. Presented are 18-month postop photos, immediate graft placement photos and a 10-day postop photo.

This patient presented with a request to strengthen a receding frontal hairline. His exam was unremarkable except for isolated frontotemporal recession. A session of 1328 grafts was performed to boost density within the weak recessions. Presented are four year postop views. Included are part views through the graft zones to demonstrate the density that was achieved and immediate postop graft placement views.

This 38-year-old patient had a strip procedure done years ago at another facility. He came to me looking to restore his hairline and add more density to the frontal 1/3 of his head. He elected to go with a FUE procedure this time. He received 2,932 grafts. The breakdown was 1,136 singles, 1,231 doubles and 565 triples. These are his results 14 months post-op. The pateint is extremely happy with his results as he now can sport a new hair style without looking like he has any hair loss.

This 30 year old patient presented with a prior history of having undergone what was described as an unsuccessful FUE hair restoration. He was concerned that few grafts grew, leaving him with unacceptably low density in the transplanted frontal area. He was also bothered by unacceptable thinning in the donor harvest area that followed his procedure. His examination revealed miniaturization confined primarily to the frontal half of the male pattern region. This was associated with punctate scarring absent of hair growth that presumably arose following his original procedure. He underwent a secondary procedure in my office at which time 2090 grafts were obtained using FUE harvesting and planted into the outlined frontal recipient area. The graft harvest was strategic in attempting to avoid the previously depleted “sweet spot” of the occipital donor area so as to prevent any additional apparent thinning. The graft harvest focused primarily in the temple and lower occipital regions, which were untouched at the time of his first procedure. Presented are one year postop photos and immediate graft placement photos. Also shown is the depleted occipital donor harvest site with a #2 short-clip and a zero-guard hair length. Finally, an immediate postop photo of the temple donor harvest area contrasts the small punch openings of this session to the large-punch scars that are located toward the back of the current harvest zone.

This 33 year old patient requested a high density restoration for his receding frontal hairline. He underwent a dense-pack hairline restoration using 2926 grafts.Presented here are 9 month postoperative photos.Included are immediate postop graft placement photos and views with the hair being parted to demonstrate his graft zone density compared to the preexisting density in the midscalp region.

This 39 year old patient presented with a prior history of having undergone a single session hair transplant to enhance his frontal hairline. He felt the hairline was too high and that the existing density was insufficient for his needs. A strip harvest was recommended based on him having a linear harvest scar from his first session and because he continued to have decent elasticity in the region of that scar. A session of 2292 grafts was performed with graft placement primarily focused on lowering the hairline and enhancing density along the leading hairline edge. He returned one year later with a nice result, but sought to further enhance density throughout the frontal region, especially in the central forelock where he thought scalp skin could be visualized under bright lights and wet hair conditions. An FUE harvest was recommended as his donor area was beginning to show evidence of reduced elasticity from the prior two harvests. A session of 1200 grafts was performed using an FUE harvest with graft placement primarily focused in the central forelock and distribution moving centrifugally from the center forelock. Presented are photos showing his final result (two-year post strip harvest / one-year post FUE harvest). Included are immediate postop graft placement pics and pics which show his appearance a few days after surgery. Part-views demonstrate his final recipient site density.

This is a 35 year old patient who presented with a history of a prior hairline restoration that failed to achieve his density objectives. He was also dissatisfied with his donor scar. He first underwent a scar revision in the donor area and returned 3 months later for his hairline restoration. A total of 1800 grafts using an FUE harvest was performed to enhance his hairline density and to augment his temporal hairline. Presented here are one year postop pictures along with short-term postoperative photos of the donor and recipient sites.

This is a 53 year old male who presented to the office with a history of a prior hair transplant session that did not satisfy his density and coverage expectations. His first comment was that he wanted to “look like Elvis” and emphasized that the frontal hairline was his most important concern. He was not concerned about his crown and planned on combing his hair toward the back. His donor area had an existing scar from his previous strip harvest. He underwent a session of 3100 grafts using a strip harvest. His preoperative hairline asymmetry in which the left side was lower than the right side was corrected. His previous transplant set his widows peak at a fairly low level. He was content with that location and therefore the plan was designed to enhance the hairline that was previously created. The graft zone was buzz-cut to a very short length to optimize graft placement. Presented here are 16 month postoperative photos along with immediate and 2-day postop photos.

This 44 year old patient presented 6 years ago requesting a density boost along his frontal hairline. He has a history of using both minoxidil and finasteride. The postop photos show the stability of his density boost from 6 years earlier.

This is a 41 year old patient who requested enhancement of his receding frontal hairline. He underwent a session of 1880 grafts harvested using follicular unit extraction. Presented here are 15 month postoperative photos. Also shown are pics representative of graft placement and donor site healing.

This is a 60 year old male who requested frontal density enhancement and a better defined hairline. He underwent a 3100 graft frontal hairline restoration using a stick-and-place method for graft insertion into the recipient site. Presented here are 14 month postoperative pictures along with immediate graft placement views.

This 36 year old male requested frontal hairline and temporal point restoration. A staged restoration was performed to accommodate his desire for well-defined temporal points and a high density frontal hairline.The first stage consisted of an FUE harvest in which a total of 2815 grafts were used to establish a new hairline and to reinforce his temporal points. A second stage was performed 8 months later at which time FUE harvesting was utilized to obtain 1379 grafts for additional density enhancement within the previously grafted areas. A total of 4194 grafts were used for the entire restoration. Postop photos show his final 8 month result. Also included are pics from his first stage and part views in the hairline which reveal the density match that was obtained between the grafted area and the adjacent scalp.